Posts Tagged ‘obesity’

New Study Reveals Significant Increase in Pregnancy-Related Strokes

Monday, August 8th, 2011

A new study published in the Journal of the American Heart Association this month reveals that pregnant women have a significantly high risk of developing a stroke. According to the lead author of the study,  Dr. Elena V. Kuklina (senior service fellow and epidemiologist at the Center for Disease Control and Prevention (CDC)), “the overall rate of women having strokes while they are expecting a baby and in the three months after birth went up 54% in the 12 years leading up to 2006-07.”

This is a significant finding! To put it in context, consider the following facts about stroke:

  • Stroke is the third leading cause of death in the United States. Over 143,579 people die each year from stroke in the United States.
  • Stroke is the leading cause of serious, long-term disability in the United States.
  • Each year, about 795,000 people suffer a stroke. About 600,000 of these are first attacks, and 185,000 are recurrent attacks.
  • Nearly three-quarters of all strokes occur in people over the age of 65. The risk of having a stroke more than doubles each decade after the age of 55.
  • Strokes can – and do – occur at ANY age. Nearly one quarter of strokes occur in people under the age of 65.
  • Stroke death rates are higher for African Americans than for whites, even at younger ages.
  • Among adults age 20 and older, the prevalence of stroke in 2005 was 6,500,000 (about 2,600,000 males and 3,900,000 females).
  • On average, every 40 seconds someone in the United States has a stroke.
  • Each year, about 55,000 more women than men have a stroke.

“A stroke is an interruption of the blood supply to any part of the brain. A stroke is sometimes called a ‘brain attack.’” The following are well-recognized stroke risk factors: high blood pressures (hypertension), atrial fibrillation, diabetes, heart disease, high cholesterol, increasing age, and a family history of strokes.  Being pregnant is a risk factor in and of itself.

As part of the study, Dr. Kuklina and colleagues used information from 5 to 8 million discharge records from about 1000 hospitals. According to Dr. Kuklina, the increase in the stroke rate during pregnancy and in the 3 months after birth was mainly attributable to high blood pressure and obesity. The study enumerates these specific findings:

  • Pregnancy-related stroke hospitalizations went up by 54%, from 4,085 to 6,293 over the 12 years leading up to 2006- 07.
  • Strokes in pregnancy went up by 47% (from 0.15 to 0.22 per 1,000 deliveries).
  • Strokes recently after giving birth went up by 83% (from 0.12 to 0.22 per 1,000 deliveries).
  • Strokes during delivery did not change (they stayed at 0.27 per 1,000 deliveries).
  • In 2006-07, about 32% and 53% of women who were hospitalized after having strokes in pregnancy and shortly after giving birth respectively had either high blood pressure or heart disease.
  • Increased prevalence of these two conditions over the 12 years up to 2006-07 accounted for almost all the increase in stroke hospitalization after giving birth that occurred in the same period.

It appears that an increasingly larger number of women enter pregnancy with one or more stroke risk factors. This is particularly true with respect to hypertension and obesity. According to Dr. Kuklina, “[s]ince pregnancy by itself is a risk factor, if you have one of these other stroke risk factors, it doubles the risk.” For this reason, it is particularly important to enter pregnancy in relatively good cardiovascular health and to reduce other risk factors, if possible. If you are pregnant or plan on becoming pregnant, talk to your OB/GYN about your stroke risk factors. In collaboration with your physician, implement a plan to manage and reduce your stroke risks before, during, and after pregnancy.

Read these related blogs:

Stroke Warnings: Most People Who Experience Minor Strokes Do Not Recognize Its Symptoms

Strokes – Family History a Significant Risk Factor

Spinal Stroke: An atypical cause of back pain

Brother, will you help me? If you don’t this stroke might kill me.

Landmark NIH Clinical Trial Comparing Two Stroke Prevention Procedures Shows Surgery and Stenting Equally Safe and Effective

Parents – be aware and read this article: Children Don’t Have Strokes? Just Ask Jared About His, at Age 7 – NYTimes.com

To view our collection of educational videos about stroke, visit us at:

http://www.youtube.com/user/nashlawatty#g/c/BDCB5099E7C9F6C4

The Week in Review: did you miss last week’s posts on health, safety, medicine, law and healthcare?

Sunday, April 3rd, 2011

Last week we launched the first in a series called The Week in Review. We hope you enjoy this project as a way to catch-up on what  you may have missed in the world of health, medicine, patient safety, law and healthcare. Now for our second installment.

 

Yesterday is history. Tomorrow is a mystery. And today? Today is a gift. That’s why we call it the present.”

Inspirational  Quote from Babatunde Olatunji


 

We started the week with Part I in a series of posts intending to explore the issue of whether the ever-growing and expanding advances in medical technology are really accomplishing their goal – or what should be their goal: more efficient, effective and safe delivery of medical care.

The author, Brian Nash, poses the question, “What has technology done to improve healthcare?” Answering in part his own question, he states:

The answer, in short, is – some amazing things and some not so amazing things have taken place in terms of technological advances in healthcare. Unfortunately, as we will explore in this series, some of these technological advances have led to some catastrophic results for patients. One need look no further than how the medical institutions rushed to implement the newest, shiniest and “best” radiology machines and through their haste left in their wake scores of maimed and dead patients.

Read more – Medical Technology and Patient Safety: EMR’s, COW’s, iPads, etc – are they really doing the job?

 

Wednesday’s post by Sarah Keogh explored an often discussed but apparently not always heeded message about car seat safety. Sarah offers some “tips” and suggestions on how to implement simple safety steps to decrease the likelihood of injuries to children while in our cars. She reported -

A recent article on healthychildren.org says that deaths in motor vehicle crashes are still the leading cause of death for young children.

Don’t let this message go unheeded. These are not Sarah’s “tips and tricks” but those of experts in the field of child safety.

Read Sarah’s piece – 4 Tips for Car Seat Safety.

 

The end of last week brought an “interesting” piece by Mike Sanders, also a lawyer with our firm, concerning a so-called study suggesting a possible link between religious activity and obesity. This wasn’t – Mike is quick to point out – a “theory” of his. This was a posting he saw and just couldn’t stop himself from writing about.

While I am usually reluctant to belittle medical research, this study really has me scratching my head and asking, “Who cares?” Before anyone decides to skip church this weekend, let’s look at the details of the study.

Makes one wonder what it takes in today’s world of instant news, internet publishing and blog posting (hmmm), to “get published” as a study.

Read Mike’s piece entitled Can Religion Make You Fat?

The Week Ahead

This coming week will have among its postings Part II in the series about Medical Technology and whether it is doing its job of advancing the safe delivery of healthcare to our population. We’ll start with a topic that is near and dear to all in the healthcare industry – EMR’s – better known as Electronic Medical Records. Sounds like a good idea – right? Since we live in a world of computers, radio buttons and drop down boxes and way too many of us in the field of medical malpractice litigation have made too many visits to the eye doctor from having to reading hand-written medical charts – why wouldn’t this be the next best thing to sliced bread? Well – read Part II coming this week.

We also plan on posting some information and analysis of a medical/anesthesia procedure – the epidural – that thousands of women have every day of every week throughout this country and the world. Well, are they really as safe as some would have you believe? Stay tuned and read our upcoming post.

There are likely to be even more goodies on health, law, patient safety and healthcare in next week’s The Eye Opener from Nash & Associates.

 


Can religion make you fat?

Friday, April 1st, 2011

Last week this blog addressed the issue of obesity and the possibility that it could be reduced with breastfeeding. Continuing with the topic of obesity, there is a recent study put out by the American Heart Association (and reported by Medical News Today) that is sure to stir up some controversy. The authors of that study claim there is a link between religious activities during young adulthood and obesity later on in life.  While I am usually reluctant to belittle medical research, this study really has me scratching my head and asking, “Who cares?” Before anyone decides to skip church this weekend, let’s look at the details of the study.

The study was actually a long-term study with a high number of participants, which generally tends to give clearer answers than short-term studies with fewer participants:

The study, involving 32,433 individuals from the longitudinal CARDIA (Coronary Artery Risk Development in Young Adults), aged from 20 to 32 years initially, were monitored for 18 years.

However, even with a high number of participants, I am very leery of the results of this study and what it has to do with our health. In terms of what the study found, the authors claim that “those who attended at least one religious event per week had almost twice the risk of becoming obese between early adulthood and middle age compared to those who had no religious commitments.” As everyone knows, obesity is just one factor that can impact a person’s overall health and life expectancy. As the authors of the study recognize, there are a number of factors that can influence heart health – blood pressure, obesity, smoking status, diabetes, high cholesterol. Obesity was the only factor that appeared to be linked to religious activity. The other factors did not appear to have any link.

Why just obesity? It is impossible to answer. Personally, I have a difficult time understanding any possible link between religious activities and obesity, and the study does not actually answer the question of what it is about religious services that may lead to obesity. They theorize that perhaps church activities tend to be more sedentary (more so than watching television or playing computer games?) or that perhaps it is the church get-togethers that have an abundance of fatty foods. However, sedentary activities and poor food choices permeate our entire society and are not restricted to religious people. So why would religious activity be associated with obesity? The authors don’t say, which leaves a gaping hole on the question of what are we supposed to do with this information. Are the authors suggesting it would be healthier to skip that once-a-week church event?

Recognizing that the study’s claim could be construed that church is causing people to get fat, the authors point out that overall, religious people are quite healthy (is anyone surprised?). Furthermore, the authors don’t actually advocate skipping church to lose weight.

The investigators stress that their study does not prove in any way that going to church, attending mass or other religious services makes you fat.

If that’s the case, then I wonder what is the purpose of reporting the study. Usually a medical study into an aspect of health will carry some recommendation of a behavioral change, e.g., avoid saturated fats, get more Vitamin D, etc. With this religion study, there is no recommendation for a change in behavior and there is no explanation for why religious activity would be problematic in terms of health. So all we’re left with is a possible statistical association with no answers as to why and no call for a change in behavior. Which takes me back to my original thought — who cares? If a study has no answers and no recommendations, then perhaps the study didn’t need to see the light of day.

I would also point out that other studies have looked at the link between religion and health and found that regular religious activity actually improves health and leads to longer life expectancy. However, that study also could not explain the specific reasons for its conclusions. Such studies are notoriously difficult to conduct because they are observational only rather than studies where the researchers can control external factors. There are so many factors that go into one’s overall health that it is difficult to single out any one activity as being blame-worthy, especially one as nebulous as attending a church activity once per week.

One encouraging — if simplistic — aspect of the study is that it may cause some churches to include a message of nutrition and exercise for their congregation. But did we really need a long-term study with thousands of participants to tell us that? We should all eat better and exercise more, regardless of our religious affiliation or preferences.

I would be curious to hear from our readers whether they think this claim has any merit or not, and what the reason for the alleged link may be. And the choir said, Amen! What say you?

 

Decreasing Obesity Risks in Children: Another Benefit of Breastfeeding

Friday, March 25th, 2011

Image from fooducate.com

In the United States today, one of the major health problems is obesity. The CDC reports that “[i]n 2009, only Colorado and the District of Columbia had a prevalence of obesity less than 20%.”  The number of both adults and children who are obese is huge and continues to rise dramatically.  The CDC website provides maps that show just how prevalent this problem is in our country. Particularly troubling is that “[t]hirty-three states had a prevalence equal to or greater than 25%; nine of these states (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia) had a prevalence of obesity equal to or greater than 30%).  This represents an enormous number of people in our country who are at risk for major health complications, such as “cardiovascular disease, certain types of cancer, and type 2 diabetes.”

While there has been an emphasis in our country on various ways to decrease these obesity statistics (including improving nutrition and increasing exercise), I wonder whether additional emphasis should be paid to children being given a great start to health. A recent article in the Baltimore Sun caught my attention. The article explains how diabetic moms, including those who had gestational diabetes during pregnancy but are not otherwise diabetic, are both more likely to give birth to a larger than average baby and also how their child is “more likely to become obese in childhood.”  The good news, the article explains, is that:

…a new study says that if you breastfeed your baby for at least six months, your child will be no more likely to put on weight than those whose moms are not diabetic.

This is just one more example of how breastfeeding for at least six months can dramatically improve your child’s chances of lifelong health.  Through breastfeeding alone, these moms can erase the increased risk that these children will become obese.

What they found appears to be a real advantage for breastfeeding: If the babies had been breastfed for six months or more, children born to diabetic moms looked nearly the same as the children of non-diabetic moms. And they were no more likely to be obese.

On the other hand, children who were breastfed for less than six months — and who had been exposed to diabetes in the womb — had significantly higher BMIs, thicker waists and stored more fat around their midsections than the other children in the study.

While I was excited to read about one more reason to support breastfeeding, I was concerned about whether this is a realistic choice for many families in our country.  Many moms who are committed to breastfeeding their children and who are successful at the start, do not continue breastfeeding for at least six months. The CDC Breastfeeding Report Card for 2010 says that “…3 out of every 4 new mothers in the United States now starts out breastfeeding… However, rates of breastfeeding at 6 and 12 months as well as rates of exclusive breastfeeding at 3 and 6 months remain stagnant and low.”  The national average is that while 75% of moms have breastfed, only 43% are breastfeeding at all at 6 months and only a mere 13.3% are exclusively breastfeeding at 6 months.  At 3 months, a time when infants would not have started solid food, only 33% of moms are still exclusively breastfeeding.  This means that there is a large drop off from what moms do when their babies are born and what they are doing by the time their babies reach 3 months.

However, the study about diabetes found that at least six months of breastfeeding was essential in protecting these kids from the increased risks of obesity. From both personal experience and anecdotal evidence, I suspect that many families are facing hard decisions about employment and breastfeeding. I suspect that a significant part of the large drop off between the numbers of moms’ breastfeeding at birth and those breastfeeding exclusively at 3 months has to do with employment. Given that the US lags so far behind other countries in paid parental leave, most moms have no choice but to go back to work full-time by the time their infants are 3 months (if not earlier).  Many moms face no choice at that point but to stop or severely limit breastfeeding, as few employers offer the time, space or scheduling to truly make moms successful at the difficult job of trying to pump while working.

I believe that the health care costs of treating individuals with obesity and all of the associated health problems should be examined against the costs of providing more complete support to new families.  What do you think?  Could employers better support breastfeeding in an attempt to increase the number of healthy children whose risks of obesity are lowered? Do you think that lack of paid leave or increased support in the workplace for breastfeeding is really the reason for decreased breastfeeding or are there other factors at play?

 

 

Lap-Band (Weight Loss) Surgery: is it for you? FDA clears new Allergan system and opens door to more patients

Monday, February 21st, 2011

The FDA recently approved Allergan’s Lap-Band weight loss surgery (which is a form of what is known as bariatric surgery). By its 8-2 vote, the FDA cleared the way for patients who are significantly less obese (BMI of 30) than those who would have qualified for weight loss surgery before this recent approval.

Knowing that this controversial clearance vote was on the horizon, major news networks aired stories on the pro’s and con’s of “broadening the base” of patients, who would now qualify. Here’s a report by ABC News’ Diane Sawyer in December 2010. (Sorry about the lead-in ad. If it were not a good report, I would have found something “ad-less” to present the issue!)

With the FDA’s announcement came somewhat of a firestorm of criticism. As reported locally in the Baltimore Sun (actually written by Thomas H. Maugh II of the Los Angeles Times), the approval has raised “concerns” by many in the medical community, who fear that this surgery will now be seen as a “quick fix” to the obesity plague in this country.

“I’m very concerned,” said Dr. Ted Khalili, former director of bariatric surgery at Cedars-Sinai hospital and founder of the Khalili Center for Bariatric Care in Beverly Hills. “You can’t be driving down a street and have a flashbulb go off and think that this will be an easy fix.”

What Dr. Khalili seems to be referring to is a marketing drive that directs patients to clinics that perform the procedure using the Allergan device. Here’s (to the right) a photo that shows exactly what this is all about.

Patient deaths following procedure lead to litigation in California

Maugh reports in his piece in the LA Times that four patients have died following the Allergan lap-band procedure. Lawsuits have followed. In a related article by another Los Angeles Times reporter, some details emerge.

Laura Faitro of Simi Valley died July 26, 2010, five days after surgery at Valley Surgical Center in West Hills. Three other patients have died shortly after surgery at an associated center in Beverly Hills, relatives have alleged in lawsuits and interviews.

Supporters speak out as well

While there are many who have decried the FDA’s approval and the lowering of the qualification standards to undergo this new lap-band procedure, there are certainly those who are in support of its potential therapeutic effects:

For those with Type 2 diabetes, the Lap-Band could be an immediate fix. “This operation takes about an hour, and two days in the hospital, and these people go off their diabetes medication. It’s unbelievable,” Dr. Walter J. Pories, a professor of surgery at East Carolina University and a leading researcher on weight-loss surgery, said in this L.A. Times report.

All surgery – including this new lap-band procedure – has significant risks

Whether one should consider taking advantage of this new procedure is a matter between the patient and his/her surgeon. After advising that not all risks or complications of undergoing this new procedure are listed in its website overview, the product’s manufacturer, Allergan, provides the following information:

Placement of the LAP-BAND® System is major surgery and, as with any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body.

Band slippage, erosion and deflation, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required.

Rapid weight loss may result in complications that may require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.

While many people seem to be intrigued by a “quick fix” surgical method of weight loss, some necessary clearance hurdles stand in the way – and should! Allergan is requiring all surgeons who want to order and perform surgery with the manufacturer’s new device “to first complete a comprehensive proctorship and training program, have advanced laparoscopic skills and (we believe this is key) have the staff and resources needed to comply with the long-term follow-up requirements of obesity procedures.”

I would add here that in our experience of handling lawsuits involving catastrophic injuries and death claims following bariatric procedures, issues relating to selection of proper surgical candidates and post-procedure follow-up and compliance have many times been at the core of these cases.

Not a “quick fix” replacement for exercise, diet and possible medication

As anyone who has been involved in any manner with issues relating to bariatric, weight-loss surgery, this is not the first step to be taken toward losing weight. Sure, it sounds enticing to go into a clinic or hospital, have a one hour procedure, and all your weight issues are a thing of the past. First of all, that is not how this works at all. Pre-procedure clearance does and must be taken seriously and not be a mere sham.

There is no doubt that there is a financial benefit for the providers of this procedure; it is reported that it will cost approximately $25,000 for the device, surgeon and operating room costs. It is also said that many insurance policies may cover all or part of this cost. That being said, even Allergan cautions that this is not a drive-by way to achieve weight loss. Read its Lap-Band System Fact Sheet and Lap-Band Labeling and Safety Information if you are interested in knowing more about the indications, alternatives, risks, benefits and advantages of this newly approved system. In addition, make certain that the surgeon you are consulting meets the qualifying standards of the manufacturer. Ask questions – it’s your body, your life.

As a side note, in case you are wondering if your BMI qualifies you for consideration of this procedure, here’s a handy BMI calculator made available online by the National Heart Blood Lung Institute – Calculate your BMI.

Know anyone who has had this or other forms of weight loss surgery?

If you or someone you know has undergone a procedure involving this new device by Allergan, share your story with our readers. If you or someone you know has undergone bariatric surgery, we also invite you to please share your story of how this worked for you or those you may know. Has it changed your or their life? If so – for the better or worse?

Body Image, Ideal Body Weight and Overall Health – A Message from the Nutcracker’s Ringer and Macaulay Fiasco.

Friday, December 31st, 2010

Jennifer Ringer

After the season of over-indulging, during which most Americans gain 5 to 15 pounds, there is usually the New Year’s resolution to lose 10 to 15 pounds (or more!).  Television commercials switch from luscious desserts to weight-loss products, the ab-roller and the amazing Bow-flex personal gym.  Department stores advertise every possible gym and exercise apparel as being “on sale” to cash in on the hype. It goes on and on; every year it’s the same.  For gym-goers, the gym is much more crowded than ever with increased wait-times for treadmills, elliptical trainers and exercise bikes.  One New York critic, however, wasted no time in telling a professional ballerina that she needed to cut back on her eating!

Alastair Macaulay, writer and critic,  attended and reviewed George Balanchine’s “The Nutcracker” at the New York Ballet.  His comments regarding Jenifer Ringer, the prima ballerina who portrayed the sugarplum fairy, stimulated much press, outrage and commentary.  Mr. Macaulay stated that Jenifer Ringer “…looked as if she ate one too many sugarplums.”  Miss Ringer appeared on the TODAY show on December 13th, and, if anyone saw the interview, she is far from being overweight! Just Google images for Jenifer Ringer, and one would be hard-pressed to criticize this beautiful young lady for being overweight.  It takes a lot of stamina, muscle strength and skill to perform in such a role as this ballerina, qualities that cannot be present when one is “starved”, anorexic or obese! Dr. Rebecca Puhl, clinical psychologist and Director of Research at the Rudd Center for Food Policy and Obesity at Yale University, wrote a blog for Medscape addressing this very issue.

So what is this stereotype? Did it actually start with Barbie dolls?

Some would say it did. The Barbie doll, marketed by Mattel, provides an image to very young girls of the “ideal” body type. Well, medical research has proven that not all body types are the same, and despite hours of exercise and regimented eating, some will never achieve the “Barbie-body.” One of the problems is that some young women actually die trying to achieve this ideal.  Anorexia and bulimia are both psychiatric conditions that have serious negative impacts on the body and its major organ systems.  Many models, and even ballerinas, struggle with body image as driven by the media and critics like Mr. Macaulay.  But so do many high school and college women!  The National Eating Disorders organization estimates that nearly 10 million women and 1 million men struggle with eating disorders in the US. For many of these individuals, it is a life-long battle with life and death!

WomensHealth.gov is a government source for women’s health topics, of which “body image” is a serious topic.  The site discusses issues such as cosmetic surgery, dieting, over-eating, and over-exercising.  The site also offers additional sources for being kind to your body and fact sheets related to the various eating disorders.

In the United States, there is currently an epidemic of obesity.  It is much publicized, and changes are being made both nationally through Congress and in local school systems where healthier options are provided for school childrens’ consumption.  Some school systems have even limited the number of birthday parties and treats allowed on a monthly basis.  This is NOT a bad thing!  When one considers the complications of morbid obesity alone, the burden on healthcare and the morbidity and mortality of the associated conditions is staggering!  Diabetes, congestive heart failure, respiratory failure and cirrhosis from fatty liver disease all come to mind. Then, apply some of the surgical procedures available today (namely gastric bypass) with the associated morbidity and mortality of these procedures, and the statistics related to surgical complications and even death rise even more rapidly.

So, what is the bottom line?

MODERATION!  EATING RIGHT!  EXERCISE!

Maintaining an ideal body weight is very important to overall health, but overall health cannot be achieved through diet alone. One must exercise routinely.  This is what should be taught in schools and in the home! Binge exercising in January as part of a New Year’s resolution, only to lose one’s way as the year progresses and life gets busier, is not much different than binge-eating or binge-dieting. We are talking about lifestyle changes that incorporate healthier food choices and routine exercise on a daily basis. Given that we are all creatures of habit, this is a change that is not an easy one!  It needs to start as early as possible and be maintained as long as possible.

We also need to stifle the comments of the Mr. Macaulay’s of this world; critique the performance, not the poundage of an ideal body weight ballerina who is in excellent physical condition!  We, as a society, cannot continue to promote thinness, per se.  Promote ideal body weight, physical conditioning (including flexibility) and healthy diets, and it must start at home!

What did you think of Mr. Macaulay’s comments? Do you know someone who suffered with this body image problem? How did they work their way out of this nightmarish existence?

Related Posts: Alistair Macaulay speaks out after the firestorm he created.

Does nutrition info on fast-food menus really make a “choice” difference?

Thursday, October 14th, 2010

On the website – theheart.org, I came across an interesting piece today about a component of the Obama health-reform bill. The bill calls for fast-food chain restaurants nationwide to provide nutritional information on menu boards. The posting says that this policy is expected to be “fleshed out and implemented over the next few years.”

Putting aside the obvious discussion of why it takes “the next few years” to figure this out and get it done, I couldn’t help but wonder whether, as a person ambles up to the counter staring at the menu board to decide on today’s choice of “a heart attack in a wrapper,” this type of information would really make any difference in people’s eating habits.

Lo and behold, it turns out that studies have actually been done – albeit on a limited basis – but nonetheless some results are in.

Dr. Pooja Tandon of Seattle’s Children’s Hospital designed a implemented a prospective cohort study designed to see if menu labeling in King County, Washington, made a difference in consumer choice. King County had passed a mandatory menu labeling law. The survey/study was done to measure the difference, if any, before the new law went into effect and after as well. San Diego – where no menu labeling is required – was the “comparator group.” (No, I didn’t take statistics! Too busy studying more exciting stuff like torts).

The details of the study are set-out in theheart.org’s posting.

According to one website, which defines obesity rates as the percentage of the population with a Body Mass index (BMI)  over 30, using data from 2003 for the most part, we, in the United States, can claim we are No. 1 in the world, just ahead of places like Mexico, the United Kingdom, Slovakia and Greece. If it’s any solace, according to more recent data from the World Health Organization (2008), U.S. males over the age 15 rank 5th – behind (no pun intended) the Cook Islands, Tonga, Nauru and Samoa. U.S. females in the same age group rank 8th in female obesity. With a slight shift in position for the leaders in the male population, Egypt, Iraq and the Seychelles beat out our women.

It comes as no surprise that obese people are at significant risk for developing conditions such as diabetes mellitus, cardiovascular diseases and hypertension (think stroke). When it comes to pregnancy, obesity is a known complicating factor for problems such as increased risk of complications during pregnancy and delivery, infertility and miscarriage. Increased risk of preterm delivery and stillbirth have also been shown by some studies to exist in the obese obstetric population. Do we really need to list the potential complications of surgery for obese patients?

Back to Dr. Tandon’s study -

“Parental awareness of nutrition did seem to have an impact on what parents bought for their children, especially if their children were overweight,” Tandon said. “And in parents who reported seeing nutrition information [for the first time], the number of children’s calories went down.”

You wonder what’s in those “children’s meals”?

Strikingly, average calories in the children’s meals ranged from about 820 in Seattle up to 920 in San Diego—staggering numbers for kids whose average age was eight in this study. According to the 2005 Dietary Guidelines for Americans: Adequate Nutrients Within Calorie Needs, a moderately active eight-year-old requires about 1400 to 1600 calories per day.

Here’s hoping that it doesn’t take a “few years” for legislators to (got to love the word from the quote) flesh out and implement this program. Even if it causes some percentage of the population to pause before ordering that luscious little treat for their child, it’s a healthy start.

What appears to be evident to some degree is that “media attention and general awareness [of fast food calories]” will be the best tool in the arsenal to make people aware of what they are doing to their bodies and those of their family when they belly-up to that counter the next time. The “counter” they should be thinking of is the one on the wall – the menu with the nutrition info – hopefully sooner rather than later.

Got to go now – need to do some sit-up’s and jogging in place before I file a few more lawsuits.

OK, Couch Potatoes! Study on Health and Mortality Questions – How Long Can We Afford to Sit Each Day?

Thursday, July 29th, 2010

Have you ever added up the total amount of time that you sit everyday?  In the car, on the bus, on the train, in the office, on the couch..the list goes on and on.  Now, new information, published by The American Journal of Epidemiology, brings to the surface some enlightening and scary statistics of what happens when we “sit for too long.”

This information has saturated the internet over this past weekend.  One of many places where this information is summarized is on the MedlinePlus website.  Within the article, the statistics regarding the risks to women versus men are clearly defined:

The authors of the study analyzed responses from questionnaires filled out by 123,216 people (53,440 men and 69,776 women) with no history of disease who were participating in the Cancer Prevention II study conducted by the American Cancer Society.

Participants were followed for 14 years, from 1993 to 2006.

In the study, people were more likely to die of heart disease than cancer. After adjusting for a number of risk factors, including body mass index (BMI) and smoking, women who spent six hours a day sitting had a 37 percent increased risk of dying versus those who spent less than three hours a day on their bottoms. For men the increased risk was 17 percent.

Exercise, even a little per day, did tend to lower the mortality risk tied to sitting, the team noted. However, sitting’s influence on death risk remained significant even when activity was factored in.

On the other hand, people who sat a lot and did not exercise or stay active had an even higher mortality risk: 94 percent for women and 48 percent for men.

Exercise is important.  OK – we knew that, but what about the report that sitting’s influence on death risk remained significant even when activity was factored in? How is that problem addressed and solved?

The answer to that question is not clear.  What is clear is the relationship between a lack of activity and obesity, as well as other factors.  These biological factors are known as “inactivity physiology”.  Study lead author Dr. Alpa Patel, an epidemiologist with the American Cancer Society, states the following:

There’s a burgeoning literature evolving around “inactivity physiology.”  When muscles, especially those in the legs, are “sitting,” they stimulate or suppress various hormones which then affect triglycerides, cholesterol and other markers for heart and other diseases.

This newly-released information is sure to spark debate and concern for some time to come.  The question remains “How long can we afford to sit each day?”  I don’t know the answer, but I think I will stand up now and walk around awhile…